POSTTRAUMATIC SYNDROME DURING PREGNANCY: EXPECTATIONS AND REALITY

Iryna Zhabchenko, Svetlana Tertychnaya-Telyuk

Abstract

Aim of the research is to study identification of peculiar issues associated with psycho-emotional state and the related stress-associated hormones and micronutrients in pregnant-displace individuals for further improvement of programmes for antenatal research.

Materials and methods. In order to reach the research objective, a dynamic prospective clinical-paraclinical examination of 96 pregnant women (experimental group) – temporary displaced individuals with gestation period of more than 22 weeks who have been treated and gave birth to their children in the Central Municipal Hospital in Rubizhne and Perinatal Centre in Severodonetsk, Lugansk region. The control group consists of 39 randomly selected pregnant women for the purposes of prospective research that are living in the areas under the control of Ukraine government.

All pregnant women were examined (clinical-laboratory and special midwifery examinations), the evaluation of psycho-emotional state of examined pregnant women was conducted with the help of screening by performing clinical interviews together with routine questioning. The questionnaires that contained the questions of Spielberg’s tests in the modification of Khanin were composed in advance. Concentration of stress-associated hormones in the blood serum, Ca and Mg was identified using the method of solid-phase immuno-ferment analysis.

Results. According to the Spielberg’s test, the average score of reactive anxiety in the experimental group exceeded the analogous indicator in the control group by 1.6 times. The indicators of personal anxiety exceeded the normal indicator in the control group by 2.2 times. Of the pregnant women in the experimental group had the concentration of cortisol in the blood serum exceeded the upper physiological standard by 5.5 % and exceeded the analogous indicator in the control group by 43.4 %. The increase concentration of prolactin was yet observed in the II trimester of pregnancy if compared to the upper level of physiological standard by 13.3 %; if compared to the average indicator of this hormone in the control group - by 20.3 %. In the III trimester - concentration in both groups was within normal ranges, but in the experimental group this indicator was higher by 10.5 %. In the experimental group of pregnant women the concentration of Ca in the blood serum in comparison to the physiological standard was higher by 19.2 % and by 9.6 % higher if compared to the analogous indicator in the control group of pregnant women. At the same time, the pregnant women in the experimental group have low concentration of Mg.

Conclusions. Taking into account the identified patterns, it is useful to categorise the pregnant women from among the internally displaced individuals as the group of high risk with respect to the development of obstetric and perinatal complications.